| NPI | 1063969897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OK 1269) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OK 1269) |
| 103TH0100X Psychologist Health Service (Licence: OK 1269) | |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |